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The Affordable Care Act: What You Need to Know

Regardless of whether you support the health care changes signed into law by President Barack Obama, there are several changes now in effect for individuals and families who have a private health insurance plan.

As of September 23, 2010, the following changes took effect:

  • Young adults may remain on their parents’ plan until age 26;
  • Private health insurance companies may no longer place a lifetime limit or maximum payout on your health insurance coverage;
  • Insurance companies are prohibited from dropping coverage if an insured gets sick or made an unintentional mistake in his or her application; and
  • Insurance companies may not discriminate against children under the age of 19 with pre-existing conditions.

If you purchase or renew your insurance on or after September 23, 2010, the insurance company must:

  • provide preventative services, like mammograms and colonoscopies, without charging a copayment, coinsurance, or a deductible;
  • you have the right to appeal the company’s decision to deny you benefits with an independent body;
  • you are allowed to choose your primary care provider, including pediatricians and OB-GYN’s within your plan network without a referral; and
  • use the nearest emergency room without penalty.  You can now visit the closest ER without getting prior approval to seek services even if the ER is outside of your plan’s network and importantly they cannot require higher copayments or co-insurance for out-of-network emergency room services.

How the New Law Affects South Carolinians Who Do Not Have Insurance   

If you have been forced to go without health insurance due to a pre-existing condition, you may be eligible for your state’s “pre-existing condition” program to obtain coverage. According to the U.S. Department of Health & Human Services (HHS), South Carolina was one of twenty-two states which opted to have HHS run its pre-existing condition program.

The changes made by the Affordable Care Act are targeted to help consumers between now and 2014 when the more significant provisions of the act take effect.

Of course with the good comes the bad.  While your insurance company is required to abide by the new provisions, there is no restriction on increased cost, so you can expect an increase in your premium this year. However, as reported by WLTX, HHS, in partnership with each state, will not tolerate unjustified rate increases.

To find out more information about the Affordable Care Act and the types of coverage available, visit HHS’s website at

At Strom Law Firm, LLC, our attorneys provide comprehensive legal services designed to protect your rights and your interests. Contact us today to arrange a free case review. Our lawyers are licensed in South Carolina, New York, and Georgia.



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